According to Mudavanhu, Segalo and Fourie (2009), very few grandparents expect to raise children on a full-time basis again. If they do, they might not be afforded the time to adjust to this transition and to deal with their own emotions prior to assuming the role of caregiver. This is because they acquire these grandchildren but lose their own child in the process. The challenges confronted by aged foster parents are multiple and complex and have to be viewed within the
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intersectionality of the socio-cultural contexts in which they occur (Partab, 2012). Some of these challenges are briefly discussed below as they impact a web of associated factors.
2.8.1 Poverty
Poverty always has a human face (Schenck , Nel & Louw, 2010:354) although a clear and distinctive definiton of poverty seems contentious accross contexts. For example, Alexander (2010:137) defines poverty as “a state in which a person or family is incapable of attaining the minimum adequate standard of living”. A number of analysts have agreed that the definition of poverty goes beyond personal income in a definite period of time. For example, it also includes a lack of opportunities, lack of access to assets and credit, and social exclusion (Guthrie, 2002).
Poverty is complex and multi-faceted and fluctuates in depth and duration.
According to figures from the Presidency, using the All Media Products Survey (AMPS), the poverty line in 2007 was that 41% of South Africa’s population was living in poverty, with African households in rural areas being most affected (South African Institute of Race Relations, 2008). South Africa is classified as a middle-income country but poverty levels are still exceptionally high (Whitworth & Wilkinson, 2013). Simelane (2010:12) notes that children are most adversely affected and the [poverty] levels differ significantly by province, with the Eastern Cape and Limpopo provinces registering the worst levels of poverty. UNICEF and the Financial and Fiscal Commission of South Africa (2010:6) shared the notion that, poverty headcount rises if lower poverty lines are used due to more severe poverty amongst children than adults and that the racial dimension of child poverty is much higher amongst black children and coloured children in South Africa than among white and Indian children.
Poverty has negative effects on families and their overall functioning and it may initiate child abuse and neglect, resulting in the need for foster care. Poverty contributes to the burden of trying to meet the needs of orphans. Collins and Leibrandt (2007) also adds that the impact of HIV/AIDS in poor communities also creates and deepens poverty at the micro, mezzo and macro levels. It has been observed that grandparents have the extra burden of caring for children who are orphaned by AIDS and that they face the challenge of raising traumatised children and teenagers in extreme impoverished conditions (Tloubatla, 2009). Raniga and Simpson (2010)
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conducted a study on grandmothers in KwaZulu-Natal and found that these elderly caregivers experienced socio-economic challenges when caring for sick HIV-infected family members and children. They mostly depended on inadequate state grants to deliver the needs of the whole family. The economic challenges faced by these carers as a result of poverty are severe. Some of the challenges include, “lack of food, accessing documents for social welfare grants, poor shelter, unemployment, insufficient clothing, lack of transport, limited potable water, and limited school fees/uniforms” (Kuo & Operario, 2010:5).
The consequences of poverty are not just physical and materialist, but also impact social and economic relationships (Tloubatla, 2009). Therefore, it is not surprising that grandparents face challenges as increasing impoverishment and its attendant risks permeate their lives.
2.8.2 Contextual Challenges
Research has demonstrated the inextricable link between AIDS and poverty and argues that this is a contributory factor to orphaned and vulnerable children (Patel, 2005; Leatt, 2006). Kasiram, Dano and Partab (2006:149) acknowledged that giving has become institutionalised, although this may exacerbate the financial burden of the less financially stable in South Africa. The elderly in particular are excessively represented among the rural poor and many live on fixed incomes at or below the poverty line. Generally, there are more socio-economic challenges in rural areas than in urban areas. They are characterised by geographic isolation, low literacy levels, sparse population, poverty, limited physical and social infrastructure, and limited numbers of health professionals and services (Thomas, 2007; Clottey, 2012). Geographic isolation in rural areas comes with transportation difficulties because of distance and the lack of public transportation (Thomas, 2007; Clottey, 2012), which in turn impacts the mobility of aged caregivers when traveling for social services. Moreover, according to Kasiram et al. (2006:149), applications for grants are often tedious and time consuming processes with the applicant having to wait several months before the grant is awarded. These grants are minimal and inadequate to sustain /or complement the family’s present source of income.
Partab (2006) asserted that a vast majority of South Africans cannot afford medical insurance and are therefore exposed to public health care which can be both a frustrating and tiresome
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resource to access. According to Thomas (2007) and Clottey (2012), rural residents are more susceptible to poverty and illiteracy than those living in urban areas. Healthcare systems in rural areas are insufficient as many rural communities experience shortages of health professionals and a higher number of rural hospitals remain under financial stress. These insufficiencies also impact the health and well-being of rural residents, and for grandparent caregivers, this heightens their vulnerability in the event of illness. The general health status of rural residents is poorer than that of their urban counterparts (Thomas, 2007; Clottey, 2012).
2.8.3 Pyscho-emotional well-being
Kiggundu and Oldewage-Theron (2009) argued that extended family foster placements present additional challenges to those presented in non-kinship placements. In particular, grandmothers who provide care for their grandchildren face not only the loss of their children, but also the loss of the support that their children would have given them in their old age. Furthermore, Kiggundu and Oldewage-Theron (2009) explained that the possibility that grandparents might decease whilst still caring for their grandchildren also brings fear to the grandparents. They fear for the safety and well-being of the children and worry about who is going to take care of them when they are no longer there to do so when the biological parents are deceased, unknown or unfit.
A number of research findings indicate that meeting increased demands of the parental role is related to significantly higher levels of psychological distress among grandparent caregivers (Longoria, 2010). Furthermore, there is a range of additional factors which have been identified as contributing to increased psychological distress in grandparental caregiving, such as the behavioural problems that children give when they are placed under the care of an aged carer.
This may be determined by the support given to the carer and the magnitude of the child’s behavioural problem. According to Choi et al. (2016), children are exposed to abuse, neglect, intimate partner violence, and other types of adverse life events. They may also experience heighted emotional and behavioural problems, which can further complicate the caregiving relationship and increase stress. Participants in the study conducted by Hearle and Ruwanpura (2009) reported feeling overwhelmed in their role as caregivers, due to the challenging behaviour of the children. They reported an increase in physical violence and lack of respect from the
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children towards their foster parents, which led to feelings of resentment about their role in the children’s lives (Hearle & Ruwanpura, 2009). Being cognisant of the stressors and challenges that aged foster parents are confronted with, it is evident that these may negatively impact their pyscho-emotional well-being.
2.8.4 Physical health
A number of studies have asserted that child care exerts a toll on a grandparent’s health. Old age and sickness are also challenges that, although not specific to family members, are often experienced by grandmothers who provide foster care (Kiggundu & Oldewage-Theron, 2009).
According to Mudavanhu et al. (2009), Grandparents are also at the edge of losing their health as they advance in years. They reach a period when they are confronted with the realisation of severe restrictions on their bodies that creep in imperceptibly and gradually and they thus struggle to feed their grandchildren and nurse sick toddlers while being vulnerable to physical ailments such as backaches and chronic diseases (Phetlhu & Watson, 2014).
Tloubatla (2009) observed that grandparents struggle to receive medical treatment at clinics and state hospitals as travel long distances when obtaining medical amenities for themselves and their grandchildren. Poor health is not unavoidable in elderly persons, chronic illnesses amongst elderly caregivers are very much prevalent. According to Fuller-Thomson and Minkler (2007), elderly caregivers are regularly at risk of chronic illnesses such as arthritis, high blood pressure, and cardiovascular and respiratory conditions which may be influenced by their poor socio- economic status. As suggested by Fuller-Thomson and Minkler (2007: 05), complementing the increased health risk associated with caregiving, such grandmothers, despite an awareness of their own health problems, may prioritize their grandparental caregiving role responsibilities and, as a consequence, neglect their own health, which may exacerbate poor health and impact their coping abilities. Clearly, the competing priority of whose physical health should receive attention is a constant concern for such grandparents.
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2.8.5 Challenges related to meeting foster children’s needs
Tloubatla (2009) argued that rearing a child is not an easy task, particularly for an elderly person because there are needs and demands that should be met. Aged carers who take on the duty of caring for children are faced with multiple responsibilities. For instance, there is a need to make some changes in their home so that it can safely accommodate the foster child/ren and some homes may need to be expanded in order to create room for these children (Clottey, 2012).
Becoming a primary caregiver has been reported to result in negative social outcomes such as social isolation and role overload among elderly carers. Here again the study conducted by Raniga and Simpson (2010) revealed that a majority of grandparents were emotionally exhausted and overwhelmed with the burden of caring for sick relatives and nurturing grandchildren. There are also many other expectations from foster parents in relation to the children placed in their care. Kuo and Operario (2010) emphasized the issues of disciplining children, attending to their mourning and their emotional and physical well-being. According to Phetlhu and Watson (2014), grandparents often lack the basic skills to deal with the post-traumatic experiences of the orphans, and they also lack skills on how to deal with orphans’ deviant behaviour. They might therefore not be able to meet other needs of the children such as supervising homework and providing social support.
2.8.6 Lack of support
While placing a child in a family environment is popular and the most preferable form of alternative care, it is accompanied by less psychosocial support from child protection agencies than other out-of-home arrangements. The study by Raniga and Simpson in (2010) suggested that, with elderly caregivers of HIV infected individuals, the caregivers may experience difficulty in accessing the old age pension. The lack of financial support for these caregivers and their added responsibility of providing for HIV-infected dependents seem to be the major social problems in communities. Warwick (2013) also argued that some of the main challenges in the foster care system are unhelpful relations with the welfare agency’s social workers, difficulty in accessing high-quality services, difficulties in maintaining contact with the child’s birth parents, lack of respite care, and lack of training and support for foster parents.
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Guardians who were interviewed in Kiggundu and Oldewage-Theron’s study (2009) verbalised the difficulty that they had in providing the documentation required by the state before the grants would be issued. They had particular problems with the birth certificates of the children. Many had applied for grants but the process took such a long time that they felt that it was likely that the children in their care would have turned 18 by the time their applications were processed (Kiggundu & Oldewage-Theron, 2009). It is clear that access to government services is fraught with obstructions for the aged caregivers. Tloubatla (2009) also asserted that the burden is made heavier when government departments sometimes appear ill-equipped to assist elderly people in meeting the new demands that are placed on them. They receive limited access to information and resources to meet the demands of their newly acquired parenting roles. While there is much stress over educating children in terms of their rights and responsibilities, there appears to be limited education for grandparents on how to deal with their foster children and the fostering process (Perumal, 2011).
In many cultures, women are traditionally seen as the most suitable caregivers to children as they are nurturers by nature, while men are identified with roles that are more masculine. However, there are grandfathers who have been given the responsibility of caring for their grandchildren.
The section below will discuss the challenges that they face within this caregiving role.
2.8.7 Custodial grandfather-specific challenges
According to Mudavanhu et al. (2009), the role of a caregiver had traditionally been associated with women due to deeply entrenched gender and socio-cultural practices; however, in modern society grandfathers also assume the role of being primary carers to foster children, mostly in the absence of their deceased wives. In the study by Patrick and Tomczewski (2008), the following points were raised: Although the economic difficulty of custodial grandmothers is well known, custodial grandfathers face similar challenges. Custodial Grandfathers in grandfather-only households are less likely to be employed, less likely to own their homes, more likely to be Black, and more likely to be poor, compared to married grandfathers. The study of Patrick and Tomczewski (2008) also compared the psychological well-being of grandparents. Custodial Grandfathers reported more depressive symptoms and lower levels of social support than the
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custodial grandmothers. They also reported more disruptions in their lives due to childcare than custodial grandmothers did (Patrick and Tomczewski, 2008). However, grandfathers may also experience a loss of freedom, feel challenged by differences in current childcare from their own days as parents, and feel fearful regarding future health declines. Many custodial grandfathers also feel powerless in their role. Therefore, the notion of an aged grandfather being a foster parent to grandchildren is much more complicated than in the case of grandmothers, because women are perceived as nurturers by their feminine nature.
From a hierarchical gender lens in South Africa, it was evident that the stereotypical roles are changing. According Marsiglio and Roy (2012), men are increasinly committing to their families and the well-being of their children. The turn of the twenty-first century has seen the emergence of the new father, a man who is both a provider and a caregiver of his children.
The researcher was unsuccessful in obtaining South African statistics and research studies documenting the experiences of custodial grandfathers. Therefore, there is a need for additional studies that will examine grandfathers’ custodial experiences in order to add to scholarly knowledge in this field that will contribute to the development of programs for the support of such grandfathers.